Multidrug resistant tuberculosis: prevalence and risk factors in districts of metema and west armachiho, Northwest Ethiopia

BMC Infectious Diseases

Gemechu Kumera¹  Setegn Eshetie³  Aschalew Gelaw³  Feleke Moges³  Belay Tessema³  Feleke Mekonnen² 

[1] Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia;Management Science for Health (MSH), HEAL-TB, Gondar, Ethiopia;Department of Microbiology, School of Biomedical and Laboratory sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

关键词: Risk factors;    MDR-TB;    Tuberculosis;   

Others  :  1232808
DOI  :  10.1186/s12879-015-1202-7

 received in 2015-04-26, accepted in 2015-10-12,  发布年份 2015

【 摘 要 】

Background

Multi drug resistant tuberculosis (MDR-TB) is an emerging challenge for TB control programs globally. According to World health organization, 2012 report Ethiopia stands 15 ^thout of the 27 high priority countries in the world and 3 ^rdin Africa. Updated knowledge of the magnitude of MDR-TB is so substantial to allocate resources, and to address prevention and control measures. Therefore, the aim of this study was to assess the prevalence of MDR-TB and associated risk factors in West Armachiho and Metema districts of North Gondar.

Methods

A cross-sectional study was conducted in West Armachiho and Metema districts between February 01 and June 25, 2014. A total of 124 consecutive smear positive pulmonary tuberculosis patients were included in the study. Socio-demographic and possible risk factor data were collected using a semi-structured questionnaire. Drug susceptibility testing was first performed for rifampicin using GeneXpert MTB/RIF. For those rifampicin resistant strains, drug susceptibility testing was performed for both isoniazid and rifampicin to identify MDR-TB using the proportional method on LJ media. Data were analyzed using statistical Package SPSS version 20; binary logistic regression was used to assess the association. P-values < 0.05 were considered as statistically significant.

Results

Of 124 smear-positive pulmonary TB patients, 117 (94.4 %) were susceptible to Rifampicin, while 7 (5.7 %) were confirmed to be resistant to Rifampicin and Isoniazid. The overall prevalence of MDR-TB was 5.7 % (2.3 % among new cases and 13.9 % among previously treated cases). History of previous treatment (OR = 7, P = 0.025) was significantly associated risk factor for MDR-TB.

Conclusion

The overall prevalence of MDR-TB was 5.7 % among cases at five health centers and a history of previous treatment was found to be a risk factor for being infected by an MDR-TB strain. Therefore, maximizing early case detection and treatment, strengthening TB infection control activities and proper implementation of DOTS are recommended to reduce the burden of MDR-TB.

【 授权许可】

   
2015 Mekonnen et al.

【 参考文献 】

• [1]Global tuberculosis report. WHO Report. WHO Press, Geneva, Switzerland; 2013.
• [2]Global tuberculosis report. WHO Press, Geneva, Switzerland; 2014.
• [3]Migliori GB, Dheda K, Centis R, Mwaba P, Bates M, O’Grady J et al.. Review of multidrug resistant and extensively drug resistant TB: global perspectives with a focus on sub Saharan Africa. Trop Med Int Health. 2010; 15(9):1052-66.
• [4]Global tuberculosis report. WHO, Geneva, Switzerland; 2012. WHO/HTM/TB; 2012
• [5]Multidrug and extensively drug-resistant TB. WHO Press, Geneva, Switzerland; 2010.
• [6]Federal Minstry of Health. The first population-based national tuberculosis prevalencesurvey in Ethiopia, 2010–2011. Int J Tuberc Lung Dis. 2014;18(16):635–9.
• [7]Bruchfeld J, Aderaye G, Palme IB, Bjorvatn B, Ghebremichael S, Hoffner S et al.. Molecular epidemiology and drug resistance of Mycobacterium tuberculosis isolates from Ethiopian pulmonary tuberculosis patients with and without human immunodeficiency virus infection. J Clin Microbiol. 2002; 40(5):1636-43.
• [8]Demissie M, Gebeyehu M, Berhane Y. Primary resistance to anti-tuberculosis drugs in Addis Ababa. Ethiopia Int J Tuberc Lung Dis. 1997; 1(1):64-7.
• [9]Demissie M, Lemma E, Gebeyehu M, Lindtjorn B. Sensitivity to anti-tuberculosis drugs in HIV-positive and-negative patients in Addis Ababa. Scand J Infect Dis. 2001; 33(12):914-9.
• [10]Mekonnen D, Admassu A, Mulu W, Aramendia A, Gelaye W, Biadglegne F et al.. Multidrug and heteroresistant mycobacterium tuberculosis and associated gene. Int J Infect Dis. 2015; 25(15):00147-2.
• [11]Nigus D, Lingerew W, Beyene B, Tamiru A, Lemma M. Prevalence of multi drug resistant tuberculosis among presumptive multi drug resistant tuberculosis cases in amhara national regional state. Ethiopia J Mycobac Dis. 2014; 4(152):2161-1068.1000152.
• [12]Soraya Sgambatti de Andrade ACG, Helio Silva Sader.Antimicrobial resistance in developing countries: Springer; 2010:249–6. DOI:10.1007/978-0-387-89370-9_14.
• [13]Tessema B, Beer J, Emmrich F, Sack U, Rodloff AC. First and second-line anti-tubercu losis drug resistance in Northwest Ethiopia. Int J Tuberc Lung Dis. 2012; 16(6):805-11.
• [14]Adane K, Ameni G, Bekele S, Abebe M, Aseffa A. Prevalence and drug resistance profile of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients attending two public hospitals in East Gojjam zone, northwest Ethiopia. BMC Public Health. 2015; 15(1):572. BioMed Central Full Text
• [15]Abdella K, Abdissa K, Kebede W, Abebe G. Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia. BMC Public Health. 2015; 15(1):599. BioMed Central Full Text
• [16]Maru M, Mariam SH, Airgecho T, Gadissa E, Aseffa A. Prevalence of tuberculosis, drug susceptibility testing, and genotyping of. Tuberc Res Treat. 2015; 215015(10):9.
• [17]Biadglegne F, Sack U, Rodloff AC. Multidrug-resistant tuberculosis in Ethiopia: efforts to expand diagnostic services, treatment and care. Antimicrob Resist Infect Control. 2014; 3(1):31. BioMed Central Full Text
• [18]Deressa MA, Demissie M. Risk Factors of Multi-Drug Resistant Tuberculosis in Addis Ababa, Ethiopia: A Matched Case–control Study. Open Access Library Journal. 2014;1(3):1-8.
• [19]Hirpa S, Medhin G, Girma B, Melese M, Mekonen A, Suarez P et al.. Determinants of multidrug-resistant tuberculosis in patients who underwent first-line treatment in Addis Ababa: a case control study. BMC Public Health. 2013; 13(1):782. BioMed Central Full Text
• [20]Barroso EC, Mota RMS, Santos RO, Sousa ALO, Barroso JB, Rodrigues JLN. Risk factors for acquired multidrug-resistant tuberculosis. Jornal de Pneumologia. 2003; 29(2):89-97.